Int.J.Curr.Microbiol.App.Sci (2015) 4(1): 348-358
ISSN: 2319-7706 Volume 4 Number 1 (2015) pp. 348-358
http://www.ijcmas.com
Original Research Article
Time related emergence of bacteria and their antibiogram of infected
burns of patients during the hospital stay
Jithendra Kandati1*, Rama Mohan Pathapati2, MuniLakshmi Ponugoti1,
Madhavulu Buchineni2, Pasupuleti Sreenivasa Rao4 and Sreeram Sateesh5
1
Department of Microbiology, Narayana Medical College and Hospital,
Chinthareddypalem, Nellore, AP-524002, India
2
Department of Pharmacology, Narayana Medical College and Hospital,
Chinthareddypalem, Nellore, AP-524002, India
3
Advanced Research Center, Narayana Medical College and Hospital,
Chinthareddypalem, Nellore, AP-524002, India
5
Department of General Surgery, Narayana Medical College and Hospital,
Chinthareddypalem, Nellore, AP-524002, India
*Corresponding author
ABSTRACT
Keywords
Bacteria, burns,
antibiotic
sensitivity,
Time dependent
bacterial
emergence,
Multi drug
resistance
Infection with microbes in burns patients is a leading cause of morbidity and mortality. We
investigated the bacteriology of infected burns wounds their antibiogram. This hospital based
study was conducted during June 2011 to May 2013. Patients with greater than 25 - 30% burns
of total body surface area (TBSA) and hospitalized in burns unit for a minimal duration of
hospitalization of 7 days were included in the study. Specimens such as wound swabs, blood and
intra vascular devices were collected at the end of 1st,2nd, 3rd and 4th week, processing, isolation,
identification and antibiogram of the isolates were done as per standard procedures. 354 patients
with 188 males and 166 females with a mean age of 24±18.6 years and the TBSA percentage
was 15% (28 88%) were studied. Pseudomonas aeruginosa was the predominant isolate
(23.91%) followed by Staphylococcus aureus (18.61%) in the study. Staphylococcus aureus
dominated during the 1st week later surpassed by Pseudomonas aeruginosa throughout the study
in all cases.51.13% of blood cultures and 48.64% of IVD s were positive for growth. Greater
than 90% of isolates showed sensitivity to Carbapenems, moderate sensitivity to
Piperaciilin/tazobactam, Cefoperazone/sulbactam, Amikacin and resistance to Cefuroxime,
Amoxycillin/Clavulanic acid. Multidrug resistance was noted among the gram negative isolates.
Gram positive cocci showed 100% sensitivity to Vancomycin & Linezolid .High degree of
methicillin resistance was noted among Staphylococcus aureus and coagulase negative
staphylococci. We highlighted the time dependent emergence of bacterial pathogens and their
antibiotic sensitivity during the period of hospital stay. Most of the isolates demonstrated
multidrug resistance. Inadequate initial antimicrobial therapy for these infected patients can
result in higher morbidity and mortality. Continuous surveillance of microorganisms and their
antibiotic resistance can improve the efficacy of infection control programs in a burn unit.
Introduction
related to burn wound management and
infection control practices, still infection
remain the main cause of mortality. Several
Burn injury is a serious concern around the
world (Revathi et al., 1998). In spite of
recent advances in the health care practices
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Int.J.Curr.Microbiol.App.Sci (2015) 4(1): 348-358
reports states that nearly 75% of all deaths
based in burns patients are due to infection
(Vindenes and Bjerknes, 1995). Further,
these infected burn wounds causes delay in
epidermal maturation and deep scar
formation (Mayhall, 2002). Patients
suffering with infected burn wounds tend to
stay for a longer duration in the hospital and
are always associated with morbidity and
high rates of mortality due to sepsis when
compared with non-infected patients (Mc
Manus et al., 1994).
duration of hospital stay (Kumar et al.,
2001). Various studies have clearly
mentioned that gram positive organisms
predominate during 1st week with
replacement by gram negative bacteria in the
course of hospital stay (Kumar et al., 2001).
Irrational and long duration administration
of Oral and Intravenous antibiotics could
lead to development of antimicrobial
resistance among the pathogens and a
burning concern causing limitation in
starting the treatment of burn infection. The
present study was aimed to evaluate the
aerobic bacterial pathogens from infected
burns patients periodically during their stay
in the hospital from wound surface, blood
and intravascular devices and to study their
antibiotic sensitivity.
The surface area of burns is sterile on
admission; however microbial colonization
of the wound will take place in a time
dependent manner. In first 48hrs microbes
colonize from the skin, sweat glands and
hair follicles, whereas the next 48 72hrs
infection will arise due to pathogens from
the respiratory tract, gastrointestinal tract
and organisms from hospital environment,
which further influence the incidence of
invasive infection and the outcome of
patient management (Barret and Herndon,
2003; Erol et al., 2004; Altoparlak et al.,
2004).
This study would enable to set up a separate
burn management protocol in the hospital
which helps to start empirical systemic
antibiotic before the results of microbial
culture become available and limit the septic
episodes in the burn patients.
Materials and Methods
Previous studies clearly mentioned that from
the burn wounds numerous types of
organisms have been isolated (Agnihotri et
al., 2004; Karlowsky et al., 2004; Pruitt,
1984) such as gram positive or gram
negative bacteria. Gram positive include
Staphylococcus aureus, Coagulase negative
Staphylococci and Enterococcus spp,
whereas
Gram
negative
include
Pseudomonas aeruginosa, Acinetobacter
spp,
Escherichia
coli,
Klebsiella
pneumoniae, Enterobacter spp, Proteus spp,
and Citrobacter sp. (Karlowsky et al., 2004;
Pruitt, 1984).
This retrospective hospital based study was
conducted at Narayana medical college and
Hospital Nellore, Andhra Pradesh, India
during June 2011 to May 2013. Patients with
greater than 25 30% burns of total body
surface area (TBSA) and hospitalized in
burns unit for a minimal duration of
hospitalization of 7 days were included in
the study. Patients with partial skin
thickness burns <25% of TBSA, Full skin
thickness burns <5% and admitted after
72hrs of burn injury were excluded.
However the pathogens which cause
infections in burns patients vary from place
to place, time to time based upon the
A total of three hundred and fifty four
patients were enrolled, there were 188 males
and 166 females. Institutional ethics
committee approved the study protocol. On
349
Int.J.Curr.Microbiol.App.Sci (2015) 4(1): 348-358
admission routine investigations has been
performed and documented as requested by
treating physician. The specimens like swab,
blood and intravascular devices (IVD) from
the patients underwent routine culture tests
at regular intervals.
Cephalexin (30µg), Cefuroxime (30µg),
Cefixime (5µg), Ceftriaxone (30µg),
Cefoperazone (75µg), Amikacin (30µg),
Polymyxin
B
(300U)
Amoxycillin/
clavualnicacid (20/10µg), Cefoperazone/
sulbactam (75/30µg), Meropenem (10µg),
Doripenem
(10µg),)
and
Piperacillin/tazobactam(100/10µg).
For isolation of pathogens, sterile cotton
tipped swabs from the surface and deeper
parts of wound were collected from
admission till date of discharge or death.
Few of the swabs were collected during
surgical debridement and prior to grafting.
These swabs were placed on 5% SBA
(Sheep blood agar), MacConkey agar, and
Chocolate agar, incubated at 37oC
aerobically for 24 48 hrs.
Escherichia
coli
ATCC
25922,
Pseudomonas aeruginosa ATCC 27853 and
Staphylococcus aureus ATCC 25923 were
used as control strains.
Statistical analysis
The data was entered in excel spread sheet
and then the statistical analysis was
performed by using SPSS Version-11. The
continuous data was presented as mean and
standard deviation. The categorical data was
presented
as
actual
numbers
and
percentages.
The blood samples were collected at the end
of 1st, 2nd, 3rd and 4th week, irrespective of
presence or absence of signs and symptoms
of sepsis. The samples were processed by
automated BACTEC 3D blood culture
system. The tips of the removed IVD s were
processed on 5%SBA, Macconkey agar, and
Chocolate agar incubated at 37oC
aerobically for 24 48 hrs. All isolates were
identified using standard biochemical tests
as per CLSI guidelines (CLSI, 2008).
Results and Discussion
A suspension of each isolate was placed
with standard antibiotic discs. (Himedia Ltd,
Mumbai).and susceptibility of the isolates
was determined by Kirby-Bauer disc
diffusion method and results were
interpreted as per CLSI guidelines (CLSI,
2008).
In the present study, we demonstrated the
antibiotic sensitivity pattern of the
organism s isolated during hospital stay
among the burn injury patients. 354 patients
were studied among them there were 188
(53.2%) males and 166 (46.8%) females.
The mean age of the patients was 24±
18.6years (range 1-82years). The data
clearly indicates that the patients were
gender matched with male to female ratio
1:0.9.
Gram positive isolates were tested against
Oxacillin (1µg), Cephalothin (30µg)
Gentamicin (10µg), Amikacin (30µg),
Ofloxacin (5µg), Clindamicin (2µg),
Vancomycin
(30µg),
Amoxycillin/
clavulanicacid (20/10µg), Imipenem (10µg),
Doripenem (10µg), Mupirocin (5µg) and
Linezolid (30µg). Gram negative isolates by
The TBSA percentage was 15% (28-88%).
The most common cause of burn injury was
flame burns 262 (74%) followed by scalds
58 (16.4%), electrical 24(6.8%) and other
types 10 (2.8%). 1062 swabs were assessed,
964(90.77%) were culture positive, 98
(9.23%) sterile and 753 (78%) produced
single isolate, 174(18%) produced twin
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Int.J.Curr.Microbiol.App.Sci (2015) 4(1): 348-358
and minimum during the 1st week (13.1%).
(Table 1). Pseudomonas aeruginosa 26.8%
was the most common organism followed by
Klebsiella
pneumoniae
20.1%,
Acinetobacter baumanii 15.2%, Escherichia
coli 12.4%, Staphylococcus aureus 12.4%
and coagulase negative Staphylococci
12.3%. (Table-3& 4)
isolates and 37(4%) produced triple isolates.
Overall analysis of 2654 specimens (wound
swabs, Blood and IVD s) revealed that 1757
specimens were positive for culture and
remaining 897 were sterile. Gram negative
organisms were more common 578 (60%)
than gram positive organisms 386 (40%).
Maximum percentage of clinical isolates
were observed between 3rd and 4th week,
particularly Gram positive organisms were
predominant during the 1st week and gram
negative organisms in between 2nd and 4th
week. Pseudomonas aeruginosa 23.91%was
the most predominant isolate identified
throughout the study, followed by
Staphylococcus aureus 18.61%, and
coagulase negative Staphylococci 18.3%.
(Table-1&2)
Cultures from from the tips of 884 IVD
revealed that 48.64% were positive and
51.36% were sterile. Maximum positivity
68% was seen during the 4th week and
minimal 27% during 1st week (Table-1).
Pseudomonas aeruginosa 26.7% was the
most common organism followed by
coagulase negative Staphylococci 23.26%,
Klebsiella
pneumoniae
18.84%,
Staphylococcus
aureus
17.67%,
Acinetobacter baumanii 8.6% and least by
Escherichia coli 4.65 %. The striking
observation
was
that
Acinetobacter
baumanii isolates were found in significant
numbers (11.83%) (Table 3and 4).
Among gram positive, Staphylococcus
aureus was the most common organism
206(21.35%) followed by coagulase
negative Staphylococci 177 (18.34%) and
Enterococci 03 (0.3%) Pseudomonas
aeruginosa was most common among gram
negative
207(21.45%)
followed
by
Klebsiella pneumoniae 133 (13.78%),
Acinetobacter baumanii 116 (12.02%),
Escherichia coli 55(5.67%), Enterobacter sp
38 (3.94%) and Proteus mirabilis 29 (3%).
We also found that a range of sensitivity
towards various antibiotics varied drastically
among the same isolate from various
specimens. For instance, Pseudomonas
aeruginosa
demonstrated
maximum
sensitivity towards carbapenems, where as
the range of sensitivity varied drastically
with Doripenem in the range of 95 99%,
Meropenem in the range of 91 98%,
Cefoperazone/sulbactam in the range of 88
92%.
Further analysis of the culture data from
wound swabs revealed that Staphylococcus
aureus was the common organism isolated
during 1st week (39.8%), Pseudomonas
aeruginosa became more common from 2nd
to 4th week (35.3%) and Staphylococcus
aureus became only 6.1% by end of the 4th
week
Moderate sensitivity was observed towards
PolymixinB (89 92%), Amikacin (87 91%)
and Piperaciilin /tazobactam (82 88%) and
less sensitivity towards Amoxycillin/
Clavulanicacid (55 57%), Ofloxacin (76
80%), Cefixime (64 72%), Ceoperazone
(81 97%), Ceftriaxone (76 81%). Similarly,
the same pattern was observed in the isolates
like Klebsiella pneumoniae, Acinetobacter
We analyzed 708 blood samples and found
that 362(51.13%) samples were positive for
culture and remaining 346(48.87%) were
sterile. The maximum growth was observed
during the 4th week of hospital stay (82%)
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Int.J.Curr.Microbiol.App.Sci (2015) 4(1): 348-358
wound infection is correlates with the extent
of the burn and is related to impaired
resistance which may results from disruption
of the skin s mechanical integrity and
generalized immune suppression. The
results of the study, confirms that
contamination of burn wound by a pathogen
occurs in almost all major burns victims.
Even application of chlorhexidine and 1%
silver sulphadiazine during the stay may not
prevent contamination showing that 81.8%
patients
reported
isolation
of
microorganisms from wound by the end of
1st week which coincides with the previous
reports (Dash et al., 2013).
baumanii, Escherichia coli, Enterobacter sp
and Proteus mirabilis which exhibited
maximum sensitivity towards Dorepenem
(96 99%),
Meropene
(92 98%),
Cefoperazone/
sulbactam
(88 92%),
Amikacin
(87 92%)
and
Pipercillin/tazobactam (83 91%) and less
sensitivity
towards
Cephalosporins,
Amoxycillin/clavulanicacid
(61 78%)
(Table 4).
Staphylococcus aureus, Coagulase negative
Staphylococci
and
Enterococci
demonstrated 100% sensitivity towards
Vancomycin and Linezolid. 90 99% was
shown towards Imipenem, Doripenem,
Mupirocin, and Amikacin. Staphylococcus
aureus
and
coagulase
negative
Staphylococci isolated from wound swabs
demonstrated 25% resistance towards
Oxacillin but the same from Blood and
IVD s demonstrated 30 35% resistance. No
resistance to Vancomycin was noted among
Enterococci (Table 5)
Multiple factors including the presence of
coagulated proteins, absence of blood borne
immune factors and the avascularity of burn
wound might promote to opportunistic
colonization by bacteria and fungi (Manson
et al., 1992).
Infections remain the primary reason for
increased morbidity and mortality in
hospitalized burn victims. In spite of early
surgical debridement,
skin
grafting,
prophylactic antibiotic administration; the
mortality associated with burn wound
infections remains high (Salah et al., 2003).
We noticed that, Gram positive cocci are
more common during the early wound
infection(1st week) followed later by
colonization of wounds with Gram negative
organisms starting by the 2nd week to 4th
week
demonstrates
time
dependent
appearance of pathogens during the hospital
stay. Our study findings are of the in line
with the study of Agnihotri et al., 2004.
Moreover in invasive burn wound infection,
Colonization of the pathogens to intra
vascular devices act as sources for the
pathogens to enter the blood stream occurs
in a time dependent manner. The studies
which describe the sources for sepsis in burn
patients and the time related changes in
these pathogens are limited (Salah et al.,
2003; Song et al., 2001). In the present
study, we assessed bacterial profile, their
antibiotic sensitivity and time dependent
changes of these pathogens during the
hospital stay .We found that the risk of burn
One of the possible explanation suggests
that gram positive organisms which are
present in the sweat glands, deep parts of
hair follicles migrate to the burn wound
during the early period, whereas Gram
negative bacteria which slowly dominate the
gram positive in the latter periods may be
either exogenous or endogenous or both.
The
exogenous
sources
include
contamination from the environment of the
burn unit and health care workers while the
endogenous
sources
include
the
gastrointestinal tract and respiratory tract.
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Int.J.Curr.Microbiol.App.Sci (2015) 4(1): 348-358
The percentage of swab culture positivity
gradually increased from 71.6% by day-3
and reached 100% by day 14th after that it
remained same on 21st and 28th day. The
overall culture positivity was 90.1%, these
results correlates with the studies of Ekrami
and Kalantar, 2007 and Bagdonas et al.,
2004. However in these studies time
dependent appearance was not noticed.
but is in contrast to other studies which
report Staphylococcus aureus as the
predominant organism (Vindenes and
Bjerknes, 1995).
The striking observation throughout the
study was high isolation rate of coagulase
negative Staphylococci throughout the
hospital stay. Several studies have urged that
coagulase negative Staphylococci should be
considered as significant pathogen in both
burn patients and critically ill patients
(Vindenes and Bjerknes, 1995). In our study
coagulase negative Staphylococci were
isolated from blood culture (12.4%), IVD s
(23.3%) and showed high resistance to
oxacillin.
Isolation
of
-hemolytic
streptococci has become rare. In addition the
nosocomial
pathogen
Acinetobacter
baumanii was demonstrated in 11.8 % of all
isolates.
Twin isolates and Triple isolates were
commonly observed during the 3rd and 4th
week.
Staphylococcus
aureus
and
Pseudomonas aeruginosa were the common
twin isolate combination followed by
coagulase negative Staphylococci and
Klebsiella pneumonia, which was also
reported in many other studies (Kumar et al.,
2011).
The minimum percentage of culture
positivity from blood culture was during 1st
week of hospital stay 13% which reached
maximum during 4th week 82% with overall
positivity of 51.13%, which was the similar
earlier (Karlowsky et al., 2004).
In our study >90% showed sensitivity to
Carbapenems, moderate sensitivity to
Piperaciilin/tazobactam,
Cefoperazone/
sulbactam, Amikacin and resistance to
Cefuroxime, Amoxycillin/Clavulanic acid
which is correlating with other studies.
Gram negative organisms are more
predominant in causing sepsis because of
their high propensity to invade and more
virulent. In our present study cultural
positivity from the tips of IVD s was
minimum during 1st week 27% and
maximum during 4th week 68% and overall
positivity was 48.6%, which may be sources
of sepsis. Staphylococcus aureus (18.6%)
was the most common organism from all
specimens during the 1st week of stay in
hospital following burn injury.
Demonstration of 100% sensitivity of
Staphylococcus aureus to Vancomycin &
Linezolid is observed in the study which is
strongly supported by other studies. 18,19
30% of Staphylococcus aureus showed
methicillin
resistance
which
is
a
significantly alarming condition Few studies
in India have demonstrated almost 50-70%
resistant to methicillin (Karlowsky et al.,
2004; Rajput et al., 2008). Significant
sensitivity was noted to Mupirocin,
Imipenem,
Dorepenem,
Clindamycin,
Amikacin & Ofloxacin. Less degree of
sensitivity was noted to Amoxyclav,
Oxacillin & Cephalothin.
Pseudomonas aeruginosa became more
common than Staphylococcus aureus in the
next all weeks. This finding of our study is
strongly in accordance with many studies in
and outside India (Atoyebi et al., 1992;
Revathi et al., 1998; Agnihotri et al., 2004)
Pseudomonas aeruginosa has demonstrated
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Int.J.Curr.Microbiol.App.Sci (2015) 4(1): 348-358
high sensitivity to carbapenems and
Piperacillin/tazobactam.
Among
Carbapenems, Doripenem showed more
sensitivity when compared to Meropenem
which is supported by many studies
(Mushtaq et al., 2004). Demonstration of
multidrug resistance among other gram
negative
isolates
like
Klebsiella
pneumoniae,
Acinetobacter
baumanii,
Escherichia coli & Enterobacter was also
noticed in our study.
In conclusion we highlighted the time
dependent emergence of bacterial pathogens
and their antibiotic sensitivity during the
period of hospital stay. Most of the isolates
demonstrated
multidrug
resistance.
Inadequate initial antimicrobial therapy for
these infected patients can result in higher
morbidity and mortality. Continuous
surveillance of microorganisms and their
antibiotic resistance can improve the
efficacy of infection control programs in a
burn unit.
Table.1 Time dependent emergence of pathogens from infected burn wounds
S.No
Time interval(Day)
No of cases(n)
1
2
3
4
5
6
3
188
7
165
10
194
14
192
21
144
28
179
TOTAL
1062
Microbial pattern in Blood culture
6
7
145
7
14
184
8
21
224
9
28
155
TOTAL
708
Microbial pattern in intra vascular device
10
7
188
11
14
194
12
21
215
13
28
287
TOTAL
884
Bacteria Growth
Negative(%) Positive(%)
54 (28.7% )
134 (71.3 % )
30 (18.2 % )
135 (81.8 % )
14 (7.2 % )
180 (92.8% )
0
192(100%)
0
144(100%)
0
179(100%)
98(9.23%)
964(90.77%)
126(87%)
118(64%)
74(33%)
28(18%)
346(48.87%)
19(13%)
66(36%)
150 (67%)
127 (82%)
362(51.13%)
137 (73 %)
130 (67% )
95 (44% )
92 (32% )
454(51.36%)
51 (27 % )
64 (33 % )
120 (56 %)
195 (68 %)
430(48.64%)
Table.2 Time Dependent emergence of Gram positive isolates in various specimens
T.I
(D-W)
Staphylococcus aureus
n(%)
WS
BS
IVD
Coagulase negative Staphylococci
n(%)
Enterococci
n (%)
WS
WS
BS
IVD
3rd
65 (48.7)
ND
ND
51 (38.4)
ND
ND
2 (1.2)
7TH
54 (39.8)
09 (47.3) 18 (35.3)
47 (35.10
6 (31.6)
28 (54.9) 1 (0.3)
10TH
38 (21.4)
ND
ND
22 (12.4)
ND
ND
0
14TH
26 (13.3)
11 (16.7) 18 (28.2)
27 (14.4)
14 (21.20
22 (34.4) 0
21ST
12 (8.2)
15 (10)
16 (13.30) 16 (11.2)
16 (10.7)
28 (23.4) 0
28TH
11 (6.1)
10 (7.9)
24 (12.3)
14 (7.9)
8 (6.3)
22 (11.3) 0
TOTAL
327
321
WB- Wound Swab, BS- Blood Specimen, IVD- Intra Vascular Device, ND- Not Done, NI- No Isolate
354
BS
IVD
NI
NI
NI
NI
NI
NI
03
NI
NI
NI
NI
NI
NI
Int.J.Curr.Microbiol.App.Sci (2015) 4(1): 348-358
Table.3 Representation of Gram negative isolates in various specimens
T.I
(D-W)
3
7
10
14
21
28
TOTAL
E. coli
WS
n(%)
4
(3.1 )
6
(4.1)
12
(6.1)
12
(6.1 )
9
(7.1 )
13
(7.1 )
K.pneumoniae
P.aeruginosa
Acinetobacter
Enterobacter
P.mirabilis
BS
IVD
WS
BS
IVD
WS
BS
IVD
WS
BS
IVD
WS
BS
IVD
WS
BS
IVD
ND
ND
ND
ND
ND
0
ND
ND
ND
0
ND
ND
1
(5.3)
ND
1
(1.3)
ND
2
(10.5)
ND
3
(6.2)
ND
0
0
NIL
NIL
NIL
NIL
ND
ND
ND
ND
2
(1.8)
12 (6.4)
ND
ND
3
(4.5)
24
(16.0)
17
(13.4)
120
2
(3.1)
6
(5.0)
11
(5.6)
3
(2.3 )
25
(13.6)
31
(16.2 )
25
(17.1)
32
(18.1 )
3
(1.4 )
7
(5.2 )
12
(6.4)
6
(3.0 )
6
(3.1 )
4
(2.5)
ND
1
(1.3)
ND
6
(4.8)
09
(6.3)
34
(19.1)
52
(26.9)
43
(30.1 )
65
(35.3)
ND
1
(5.3)
ND
3
(2.4 )
06
(4.6)
26
(14.6)
33
(17.1 )
29
(20.4)
36
(20.4)
12
6
21
12
05
4
NIL
(18.2 )
(9.4)
(31.5)
(18.7)
(7.6)
(6.2)
31
21
38
34
26
15
NIL
(20.7)
(17.5)
(25.3)
(28.3)
(17.3)
(12.5)
32
53
36
67
24
18
NIL
(25.2 ) (27.2)
(28.3 ) (34.4)
(18.9)
(9.2)
290
420
208
38
T.I (D-W) time interval(day-week); ws: wound swab; bs :blood specimen;ivd :intra vascular device.nd:not done
NIL
6
(3.0 )
4
(2.8 )
5
(2.6 )
29
NIL
NIL
NIL
NIL
NIL
NIL
NIL
NIL
Table.4 Antibiogram of gram positive isolates (%)
ANTIBIOTIC
OXN
CTN
GM
AK
OF
AMV
VM
CD
AZM
DPM
MPN
LZ
Staphylococcus aureus
SWAB
BLOOD
IVD
74.2
64.6
64.3
81.2
74.3
67.6
91.2
85.6
86
94.3
92.4
93.4
91.2
89.4
88.7
85.6
82.1
83
100
100
100
87.2
89.7
93.5
94.2
96
93.4
93.6
99.1
99.1
94.3
90.4
93.5
100
100
100
SWAB
72.5
76.1
90.2
93.4
91
81.4
100
89.2
97.3
98.2
92.8
100
CONS
BLOOD
67.3
71.2
89.3
93
88.3
81
100
87.4
97
98.6
94.3
100
IVD
63.5
74.2
88.2
88.4
88.3
82.9
100
89.2
94
98
95.5
100
SWAB
66.6
66.6
100
100
66.6
100
100
100
100
ND
ND
100
Enterococci sp.
BLOOD
NI
NI
NI
NI
NI
NI
NI
NI
NI
NI
NI
NI
IVD
NI
NI
NI
NI
NI
NI
NI
NI
NI
NI
NI
NI
OXN : Oxacillin, CTN : Cephalothin, GM :Gentamicin,AK : Amikacin, OF : Ofloxacin, AMV : Amoxyclav, VM : vancomycin, CD :
Clindamycin, AZM : Aztreonem, DPM : Dorepenam MPN : Mupirocin, LZ: Linezolid. NI : not isolated
355
Int.J.Curr.Microbiol.App.Sci (2015) 4(1): 348-358
Table.5 Antibiogram of gram negative isolates of the study (%)
ABC
P.aeruginosa
K.pneumoniae
A.baumanii
WS
BC
IVD
WS
BC
IVD
WS
BC
CPX
ND
ND
ND
51.7
68.1
68.1
ND
ND
CFR
30.1
48.2
50.3
57.2
67.1
68.8
27.2
38.3
CFX
64.2
72.2
64.3
73.2
73.2
73
65.6
77.3
CTX
76.9
81.1
80.3
86.3
89.3
88.5
67.8
72.1
CFP
82.2
87.1
81.3
84.2
87.2
88.7
80.6
86.4
OF
76.4
77.2
79.4
81.2
83.4
82.9
78.8
80
AMV
56.9
58.3
55.2
74.2
78.2
77.8
61.2
68.2
PTZ
82.2
84.5
88.4
87.2
87.2
88.7
83.4
87.3
CSM
91.2
93
91.2
87.3
90.2
89.5
88.3
88.3
AK
87.2
90.3
90
89.5
89.5
87.6
89.2
92.1
PB
89.5
92.1
91
ND
ND
ND
ND
ND
MPM
91
92
91.4
93.2
93.2
93
92.5
93
DPM
93.4
94
93
95.5
94
91.3
94.5
94.5
ABC: antibiotic; WS: wound swab; BC: Blood culture; IVD: Intra vascular device;.CPX: Cephalexin; CFR: Cefuroxime; CFX: Cefixime; CTX:Ceftriaxone; CFP: Cefoperazone; O
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